Related Experiment Videos
[Clinical and EEG evaluation of mid-line spikes in childhood]
T Konishi1, Y Naganuma, K Hongou
1Department of Pediatrics, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Japan.
Insights
Mid-line spikes, a childhood EEG pattern, occurred in 3% of cases. While often associated with seizures, they may not strongly correlate with clinical epilepsy, showing good seizure control in most patients.
Area of Science:
- Neurology
- Pediatric Neurology
- Clinical Neurophysiology
Context:
- Mid-line spikes are an electroencephalographic (EEG) finding observed in children.
- The incidence of mid-line spikes in the pediatric EEG population is approximately 3.0%.
Purpose:
- To investigate the clinical and electroencephalographic (EEG) characteristics of mid-line spikes in a pediatric cohort.
- To determine the correlation between mid-line spikes and clinical seizures, family history, and other neurological symptoms.
Summary:
- This study analyzed 45 pediatric patients with mid-line spikes, noting their onset between one month and 12 years (mean 5.0 years).
- While 71% had a history of seizures (febrile or epileptic), 29% did not, suggesting mid-line spikes may not strongly correlate with clinical seizures.
- Generalized tonic-clonic seizures were most frequent, and partial seizure symptoms varied, potentially indicating other brain lesions. Seizure control was generally good.
Impact:
- Findings suggest mid-line spikes, despite association with seizures, may not be a definitive marker for epilepsy, aiding in differential diagnosis.
- Understanding the varied clinical presentations associated with mid-line spikes can improve patient management and prognosis.
- This research contributes to the neurophysiological understanding of spike patterns in childhood epilepsy and related neurological conditions.
Abstract:
We studied the clinical and electroencephalographic (EEG) characteristics of 45 patients with mid-line spikes. The incidence of mid-line spikes was 3.0% in total EEG population in childhood. Sex incidence was equal. First appearance age of mid-line spikes ranged from one month to 12 years, with a mean of 5.0 years old. Fz focus was in 3 patients, Cz in 31 and Pz in 11. Thirty two of the 45 patients (71%) had a history of clinical seizures; 16 with febrile convulsions and 16 with epileptic seizures. Of the remaining 13 patients without a history of seizures, the EEG was obtained because of post-meningitis in 4, developmental delayed in 4, migraine in 1 and miscellaneous in 4. Mid-line spikes might not have so strong correlations with clinical seizures. Ten patients had a family history of epilepsy and/or febrile convulsion. In the patients with seizures, generalized tonic-clonic seizures were the most frequent type (18; primary GTC and 10; secondary GTC with partial onset). Elementary symptoms of partial seizures were very variable (focal motor in 5, Jacksonian march in 1, aversive in 1, autonomic in 2 and automatism in 5), and which might be related to the other lesions such as temporal and/or frontal lobes. Seizure control was almost good except for two patients with organic brain damage. And other neurological symptoms were not also progressive. On EEG findings, twenty-two patients had midline spikes as their only epileptiform abnormality. The remaining twenty-three had an additional epileptiform feature, either a focal spikes or a generalized spike-wave.(ABSTRACT TRUNCATED AT 250 WORDS)